LECTURE 3 ANATOMY OF LOWER LIMB Flashcards
what is the function of the sacrum?
sacrum weight bears and transmit force to lower limbs- firm, secure & tight
what is nutation & counternutation of the sacrum?
to nutate= bend forward, counternutate= nod backwards
what are the joints of the pelvis?
sacro-iliac joints & pubic symphysis
what type of joint is sacro-iliac joint?
synovial joint but becomes fibrous by mid 60’s
what type of joint is pubic symphysis?
fibrocartilaginous with disc
what are the ligaments of the pelvis?
sacroiliac, inguinal, iliolumber, sacrospinous, sacrotuberous- non capsular
where does the sacroiliac lig. begin & end?
sacrum to iliac
where does the inguinal lig. begin & end?
pubic tubercle to anterior superior iliac spine
where does the iliolumbar lig. begin & end?
lumber transverse vertebrae to iliac crest- restricts destraction of joint
where does sacrospinous lig. begin & end?
sacrum to ischial spine- prevents coccyx going up when pelvis nutates/goes forwards
where does sacrotuberous lig. begin & end?
sacrum to ischial tuberosity- prevents coccyx going up when pelvis nutates/goes forwards
what are the movements of the hip joint?
ball & socket- flexion/extension, abduction/adduction, medial/lateral rotation
what are the ligaments of the hip join?
iliofemoral (prevents extension & abduction), pubofemoral (abduction & internal rotation), ischiofemoral (resists extension)- all capsular
what is the function of hip joints ligs.?
limits hip extension
what is the function of the ligamentun teres?
transmits an artery to head of femur- in infant, it’s role is to transmit a nutrient artery to femoral head epiphysis- feed epiphyseal plates in children & prevents axial load with external rotation
where does the ligamentum teres begin & end?
passes from transverse ligament & acetabular notch of acetabulum to femoral head where it insert into fovea capitis (shallow depression)
what are the muscles acting on hips?
iliopsoas (flex), adductors, quadriceps femoris (flex hip, extend knee), gluteus maximus (extend hip, flexes knee) & medius, hamstrings
what muscles flex hip?
iliopsoas, rectus femoris (quads), adductors
what muscles extend hips?
gluteus maximus (also abducts), hamstrings
where does the iliopsoas originate & insert?
iliac fossa & lumbar spine to lesser trochanter of femur
what supplies the iliopsoas?
medial femoral circumflex artery & iliolumbar artery
what innervate iliopsoas?
branches from L1 to L3
what is iliopsoas main action?
flexion of hip
what is iliopsoas antagonist?
gluteus maximus & posterior compartment of thigh
what makes up adductors muscles?
adductor brevis, longus, magnus- pectineus- gracilis- obturator externus
where do the adductor muscles arise & insert?
pubis to femur & tibia
what supplies the adductor muscles?
obturator nerve
what are the actions of adductor muscles?
adduction of hip
what makes up quadriceps femoris?
rectus femoris, vastus lateralis, intermedius, medialis
what is the origin & insertion of quads?
rectus femoris and vastus muscles to tibial tuberosity
what supplies & innervates quads?
femoral artery & nerve
what is the role of quads?
knee extension & hip flexion via rectus femoris
what is the origin & insertion of gluteal maximus?
gluteal surface of ilium, lumbar fascia, sacrum, sacrotuberous lig. to gluteal tuberosity of femus & iliotibial tracT
what is the action of the gluteal maximus?
external rotation & extension of hip joint and supports extended knee, antigravity muscle in sitting & abduction of hip
what is the origin & insertion of gluteal medius?
gluteal surface of ilium to greater trochanter of femur
what is the action of gluteal medius?
abduction of hip, prevents adduction of hip, medial & internal rotation & flexion of hip, extension & lateral/external rotation of hip
what is the action of the hemstrings?
flexion of knee & extension of hip
what is the function of piriformis & deep gluteals?
external rotator of thigh- draws hips into acetabulum
what is the knee stabilised by?
anterior & posterior cruciate ligaments
what are the 2 joints of the knee complex?
tibiofemoral joint & patellofemoral
what is the purpose of the anterior cruciate ligaments?
resists motion anterior tibial translation (moving forward) & interior tibial rotation- accessory lig
what is the purpose of posterior cruciate ligaments?
prevent the femur from sliding off the anterior edge of the tibia and to prevent the tibia from displacing posterior to the femur- prevent anterior translation of femur & posterior translation of tibia
what type of joint is tibiofemoral joint?
a condylar/modified hinge joint
what type of movement can knee joint perform?
flexion/extension & medial/lateral rotation
what are the ligaments of knee joint?
cruciate ligs., lateral & medial collateral ligs., medial & lateral meniscus
what is the role of menisci?
improve fit, absorbs and distribute shock- creates SA to absorb shock & spread synovial fluid
what is the function of medial collateral lig.?
resist inwards turning forces on knee- valgus movement- if lateral collateral lig shortens too much, medial collateral will snap
what is the function of lateral collateral lig.?
resists outwards turning- verus movement- if medial collateral lig shortens too much, lateral collateral will snap
what muscles act on knee?
sartorius, quads, hamstrings, popliteus
what is the function of sartorius?
flexion, abduction & lateral rotation of hip- flexion of knee
what is the function of hamstrings on knee?
flexion
what is the function of quads on knee?
extension
what is the function of popliteus?
medially rotates tibia on femur if femur is fixed (sitting) or laterally rotates femur on tibia if tibia is fixed (standing up)- unlocks knee to allow felxion
what muscles flex the knee joint?
sartorius, hamstrings. popliteus
what muscles facilitate rotation when knee is flex?
biceps femoris, semitendinosus, semimembranosus, gracilis, and sartorius
what muscle extend the knee joint?
quadriceps
what innervates anterior compartment of upper leg?
femoral nerve
what innervates posterior compartment of upper leg?
sciatic nerve
what innervates medial compartment of thigh?
obturator nerve
what is makes up the anterior compartment of lower leg?
tibialis anterior, extensor hallucis longus, entensor digitorum longus
what is the action of tibialis anterior?
dorsiflexion & inversion of foot
what is action of extensor hallucis longus?
Extends the big toe and assists in dorsiflexion of the foot at the ankle.
what is action of extensor digitorum longus?
extension of toes and dorsiflexion of ankle
what innervates anterior compartment of lower leg?
deep peroneal nerve
what makes up lateral compartment of lower leg?
fibularis (peroneus) longus & brevis
what is the action of fibularis (peroneus longus & brevis)?
plantarflexion of ankle & eversion of foot
what innervates the fibularis longus & brevis?
superficial peroneal nerve
what makes up superficial group of posterior compartment of leg?
gastrocnemius & soleus
what are the actions of gastrocnemius & soleus?
plantar flexes foot & flexes knee
what are the deep muscles of posterior compartment of leg?
tibialis posterior, flexor digitorum longus, flexor hallucis longus
what is the action of tibialis posterior?
Inversion of the foot and plantar flexion of the foot at the ankle
what is the action of flexor digitorum longus?
Flexion of the four smaller digits
what is action of flexor hallucis longus?
flexion of big toe
what innervates posterior compartment of lower leg?
tibial nerve
what are the movements of ankle & sub-talar joint?
plantarflexion/dorsiflexion & inversion/eversion
what are the ligs. of ankle?
deltoid ligaments, anterior & posterior talofibular ligament, calcaneofibular, lateral collated ligament
what are the tarsals of the foot?
talus (ankle bone), calcaneus (heel bone), navicular, cuboid, cuneiforms
what is the medial collateral lig./deltoid lig?
medial malleolus to tarsal bone- consists of multiple layers
what is the function of deltoid lig.?
valgus tilting & eversion
what does the lateral collateral ligament of ankle joint consist of?
anterior & posterior talofibular & calcaneofibular
what is the function of the anterior talofibular lig.?
prevents foot sliding forward in relation to shin
what is the overall function of lateral collateral ligament of ankle?
prevent verus tilting & inversion
what is the function malleoli of the ankle?
forms a mortise which stabilises ankle joint
what are the 2 plexuses supplying the lower limb?
lumbar (L1-L4) & lumbosacral (L4-S2)
where does the femoral nerve arise from?
lumbar plexus of L1 to L4- anterior & medial thigh compartment- gives rise to femoral & obturator
what does the femoral nerve supply?
anterior compartment of leg e.g. quads (muscles the flex the hip, extend the knee)
what does the obturator nerve supply & arise from?
medial compartment of thigh- from lumbar plexus of L2-L4
where does the sciatic nerve rise from?
lumbar & sacral plaexus (L4-S3)
where does the sciatic nerve emerge from?
emerges below piriformis
what does the sciatic nerve supply?
posterior thigh compartment (hamstrings- hip flexion & knee flexion)
what does the sciatic nerve branch to?
tibial & common fibular (peroneal) nerve
what does the tibial nerve innervate?
posterior thigh compartment- superficial (gastrocnemius & soleus= plantarflexion) & deep (tib post, flexor hallucis & digitorum longus= foot inversion & toe flexion)
what does the common penoeal/fibularis nerve divide into?
superficial & deep as it winds around head of fibula
what does the superficial peroneal supply?
lateral leg department e.g. peroneus longus & brevis (foot eversion)
what does the deep peroneal supply?
anterior leg department e.g. tib ant, extensor hallucis & digitorium longus (dorsiflexion, foot inversion, toe extension
what is the artery path of the leg?
abdominal aorta- common iliac- external iliac, femoral, popliteal, anterior & posterior tibial arteries, dorsalis pedis artery
when does the external iliac change to femoral artery?
when it passes inguinal ligament
what does the femoral artery give rise to?
circumflex artery & gives blood to neck & head of femur
what does the femoral artery supply?
anterior compartment of leg
when does the femoral artery change to popliteal artery?
inside adductor magnus
what does the popliteal artery supply?
hamstrings, gastrocnemeus, soleus- sits in popliteal fossa
what does the popliteal artery give rise to?
anterior & posterior tibial artery
what does the anterior tibial artery supply?
anterior compartment of leg
what does the posterior tibial artery supply?
posterior compartment of lower leg & plantar surface of foot
what does the anterior tibial artery give rise to?
dorsalis pedis artery
what does the dorsalis pedis artery supply?
dorsal surface of foot
what are the deep veins of legs?
dorsal venous plexus to anterior & posterior tibial vein to popliteal vein to femoral vein to external iliac to IVC- have venae comitantes to help with venous return
what are the superficial veins of legs?
great saphenous & short saphenous
where does the great saphenous vein begin & end?
dorsal venous arch of foot to femoral vein
where does the small saphenous vein begin & end?
dorsal venous arch of foot to popliteal vein
In an elbow x-ray, the coronoid fossa appears more radiopaque than the olecranon process. True or False
FALSE
The elbow complex consists of the ulnohumeral and radiohumeral joints. True or False
TRUE
The collateral ligaments of the radiocarpal joint primarily limits movement in which anatomical plane of movement?
CORONAL PLANE
The brachial artery is distal to the axillary artery. True or False
TRUE
Which vein drains directly into the superior vena cava if the blood is coming from the upper extremity?
subclavian
